Padmashri award winner and surgeon, Pradeep Chowbey suggests treatment and prevention options for painful piles
Piles or haemorrhoids are blood vessels in the anal and rectal area that become inflamed and swollen due to excessive pressure or strain. If the stretching and pressure continue, weakened and enlarged blood vessels protrude inside the anal canal or outside the opening.
The veins in the rectal region are in a high pressure zone that tries to pump blood back to the heart against the gravitational pull. Any condition that raises pressure in the anal canal over time results in inflammation and swelling of these blood vessels leading to piles. This could be a result of:
- Chronic constipation or diarrhoea
- Faulty bowel function due to laxatives, enemas or straining
- Spending time reading on the toilet
Symptoms and recommended diet
Piles presents as:
- Something protruding from the rectum while defecating
- Faecal soiling, itching and pain
Fibre adds bulk and moisture to the stool, and speeds movement through the intestines. A high-fibre diet of fruits, legumes, vegetables, whole grain breads, cereals, beans, brown rice, nuts and seeds, fruits and vegetables is recommended.
Adequate fluid helps in prevention. Drinking eight glasses of water daily softens the stools.
- Avoid food like refined white rice, white bread, and cakes, alcohol, acid forming foods such as sugar, meats, dairy, and caffeine-containing food and beverages, and soda drinks.
- Avoiding straining in the toilet.
- Increased fibre prevents constipation and straining.
- Follow regular bowel habits.
- Exercise and walking helps.
- Bathing in tubs in a Sitz bath with warm water eases pain in the early stages.
Diet changes, exercise and local anaesthetic gels benefit in early stages. Persistent piles need treatment. These include:
- Minimally invasive procedure for haemorrhoids or MIPH is the current recommended procedure. It uses a transanal stapling device that disrupts blood flow to piles. It is painless, needs no dressing and heals fast.
- Sclerotherapy involves injection of a sclerosing agent, such as phenol.
- Haemorrhoidectomy is surgical excision of piles. There is significant post operative pain, dressings and recovery takes four weeks.
- A number of cautery methods are effective. This uses electrocautery, infrared radiation, laser, or cryosurgery.
- Rubber band ligation uses elastic bands to the internal pile mass to cut off blood supply.